MEDICARE: JAYLORIN GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1235980939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYLORIN GROUP INC

Provider Business Mailing Address
First Line	:	1025 E HALLANDALE BEACH BLVD STE 15-747
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4478
Country	:	US
Telephone Number	:	754-319-9039
Fax Number	:

Provider Business Practice Location Address
First Line	:	785 S STATE ROAD 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-6710
Country	:	US
Telephone Number	:	754-277-4940
Fax Number	:	754-287-2261

Authorized Official
Title or Position	:	OWNER
Name	:	DESMOND JACKSON
Credential	:
Telephone Number	:	754-319-9039

Provider Enumeration Date	:	03/29/2024
Last Update Date	:	08/30/2024

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